Ultrasound-guided parathyroid homogenate injection in anterior fascia of the flexor carpus vs. intramuscular transplantation for secondary hyperparathyroidism / 中华普通外科杂志

ABSTRACT

Objectives:To evaluate forearm intramuscular autograft Tx vs. forearm subcutaneous ultrasound-guided homogenate injection transplantation. Methods:One hundred-ten end-stage chronic renal failure patients who after total parathyroidectomy and autologous forearm Tx from Mar 2011 to Mar 2020 were enrolled for retrospective analysis.The control group received autologous parathyroid forearm intramuscular autograft Tx, and the observation group had the anterior fascia of the flexor carpus ultrasound-guided homogenate injection Tx. We evaluated the effects of transplantation between the two groups.Results:There were no significant differences in the levels of iPTH, blood calcium, blood phosphorus, and calcium-phosphorus product between the two groups of patients 30 minutes , 1 month , and 3 months after surgery.The two-dimensional ultrasound simulated ellipse dispersion volume in the observation group is much smaller than that in the control group [(2.51±0.41) cm 3vs. (1.91±0.55) cm 3, t=6.519, <0.001] The linear regression equation of the actual volume of the three-dimensional ultrasound in the observation group and the iPTH value in the observation group after 3 months is Y1=47.728+ 122.337X, r1=0.892, P<0.05. The linear regression equation of the two-dimensional ultrasound simulated ellipse diffusion volume in the observation group and the iPTH value in the observation group at 3 months after operation was Y2=121.408+ 81.736X, r2=0.883, P<0.05. Conclusion:Compared with intramuscular Tx, the recovery levels of iPTH, calcium, phosphorus and calcium-phosphorus product after the anterior fascia of the flexor carpus ultrasound-guided homogenate parathyroid glands injection Tx are similar, but its operation is more simple and diffusion volume is smaller.